Yumiko Nagao, Yutaka Kawakami, Tamotsu Yoshiyama, Michio Sata
Med Sci Monit 2008; 14(11): PI45-52
Interferon (IFN) therapy, an antiviral agent, contributes to the prevention of occurrence of hepatocellular carcinoma (HCC) and to improvement in long-term prognosis. However, IFN therapy is not well-implemented in Japan. The present study was conducted to analyze factors preventing the implementation of IFN therapy.
Material and Method: Questionnaires were sent to patients with hepatitis C virus (HCV)-related liver disease who were treated at 7 clinics (by non liver-specialists) and 1 hospital (by liver specialists) and by their attending physicians.
Results: Of 139 patients for whom attending physicians recommended IFN therapy, 92 (66.2%) agreed to receive the treatment. The proportions of patients who agreed to receive IFN therapy were 74 (86.0%) out of 86 hospital patients and 18 (34%) out of 53 clinic patients. In logistic regression analysis, the adjusted odds ratios on treatment facilities, sex and complications were 18.06, 3.65, and 3.63 respectively, indicating that there were significant differences. Female patients more than male patients declined IFN therapy because of worries over the adverse reactions of IFN therapy.
Conclusions: Multivariate analysis showed that factors contributing to the risk that a patient would not consent to receive IFN therapy included a) treatment facilities, b) sex, and c) the presence or absence of complications. It is also essential to devise measures to create cooperation between hospitals and clinics, and to improve communication between physicians and patients.
Keywords: Middle Aged, Male, Interferons - therapeutic use, Humans, Hepatitis C - pathology, Questionnaires, Female, Aged, 80 and over, Aged, Adult